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Evaluation form
Would you rate the following questions with a rating of 0-5?
1= insufficient 2= poor 3= adequate 4=good 5=very good
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* Indicates required question
Name:
*
Your answer
E-mail:
*
Your answer
Company you work for:
*
Your answer
Name coach:
*
Your answer
Did you feel heard and understood during the intake?
*
insufficient
1
2
3
4
5
very good
Did your goals become clear during the intake?
*
insufficient
1
2
3
4
5
very good
Could your appointment with the coach be made in a timely manner?
insufficient
1
2
3
4
5
very good
Clear selection
Was the location of the coach convenient for you?
insufficient
1
2
3
4
5
very good
Clear selection
Did you feel heard and understood by the coach?
*
insufficient
1
2
3
4
5
very good
To what extent did you achieve your goal?
*
insufficient
1
2
3
4
5
very good
To what extent have the sessions helped to prevent to call in sick?
insufficient
1
2
3
4
5
very good
Clear selection
What do you think in general of the guidance of ICAS Netherlands?
*
insufficient
1
2
3
4
5
very good
What was your goal for the sessions?
Your answer
What stayed with you from the sessions?
Your answer
What image did you have of ICAS Netherlands and has this picture changed?
Your answer
Remarks:
Your answer
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